The crisis has intensified during recent years, with 7,847 opioid overdose deaths in 2023 representing the highest annual toll on record for California (AP, 2024). Alcohol use disorder affects 28.9 million Americans nationwide and represents…

TCAs are anticholinergics that modulate alpha-2-adrenoreceptors, thereby decreasing sympathetic nervous system activity and mitigating brain–gut autonomic dysfunction 95. Amitryptine helps to prevent vomiting cycles in CHS, usually at doses between 50 and 200 mg daily…